Thank you for participating in 'The Threads Among Us' workshop!  Please take 10 minutes to give us your feedback.  Your answers will be anonymous, and we greatly value your time and input!

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* 1. How did you participate in "The Threads Among Us" workshop?

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* 2. What is your gender?

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* 3. What is your racial or ethnic identity? (Select all that apply.)

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* 4. What is your job title and level of experience? (Choose one from drop-down menu.)

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* 5. How often do you observe incivility IN YOUR OWN department/section/unit/specialty?

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* 6. How often do YOU cause or contribute to incivility in your
workplace?

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* 7. How often do you experience incivility directed TOWARD YOU in your workplace?

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* 8. How often do you experience incivility in OTHER departments/sections/units/specialties?

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* 9. Does your department/section/unit have well-defined policies or procedures for addressing incivility in the workplace?

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* 10. BEFORE the workshop, how comfortable were you addressing workplace incivility?

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* 11. Now, AFTER the workshop, how comfortable will you be addressing workplace incivility in the future?

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* 12. How well did the video present common scenarios of incivility between health care providers?

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* 13. In general, Activity 1 (Social Contagion) was:

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* 14. In general, Activity 2 (Video Debrief) was:

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* 15. In general, Activity 3 (The Ladder of Inference) was:

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* 16. In general, Activity 4 (Letter of Gratitude) was:

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* 17. When were you MOST engaged in the workshop? What made it so?

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* 18. When were you LEAST engaged in the workshop?  What made it so?

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* 19. What has been MOST valuable to you from the workshop in terms of your professional development?

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* 20. What has been LEAST valuable to you from the workshop, in terms of your professional development?  How would you change it?

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* 21. Would you recommend the video to others?

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* 22. Would you recommend the workshop to others?

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* 23. Do you have any other feedback?

Thank you for completing this evaluation of 'The Threads Among Us' workshop.  Be sure to click [DONE] or your answers will not be submitted.

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